Question | Answer |
what class drug is Terbutaline? | beta adrenergic agonist; autonomic nervous system agent; smooth muscle relaxant |
what is the primary use of Terbutaline? | delay delivery in preterm labor |
what class of drug is Methergine? | ergot alkaloid |
what is Methergine used for? | postpartum hemorrhage; uterine atony, sub-involution |
what are the actions of Terbutaline? | acts on beta 2 adrenergic receptors to relax smooth muscle and reduce uterine contractions. Increases uterine relaxation therefore preventing high intrauterine pressure. |
hyper/hypotension, n/v, chest pain, dyspnea, headache, hematuria, thrombophlebitis, water intoxication, hallucinations, leg cramps - side effects of what? | Methergine |
narrow angle glaucoma, DM, HTN, hyperthyroidism, severe cardiac disease are all contraindications for what med? | Terbutaline |
what are some nursing implications for Terbutaline? | Assess BP-report HR>130, assess resp rate, give 2 hrs before bedtime r/t sleeplessness, SC injection into lateral deltoid, protect from light and freezing |
contraindications for Methergine? | HYPERTENSION, eclampsia, prego |
what is the action of Methergine? | stimulates uterine and vascular smooth muscle causing contraction |
drug class: oxytocic; causes stimulation of uterine smooth muscle | Pitocin/oxytocin |
list 4 uses for Pitocin | induction/augmentation of labor; reduction of immediate postpartum bleeding; Oxytocin challenge Test(OCT); management of incomplete or inevitable abortion |
what are some contraindications for Pitocin? | severe PIH, malpresentation, fetal distress, contraindication of vaginal birth, over distended uterus, hx of uterine surgery, multiparity |
side effects of Pitocin? | uterine rupture, cervical & lower uterine lacerations, placental abruption, PE, fetal hypoxia/anoxia, tetanic contractions causing impaired uterine blood flow |
nursing implications for Pitocin | may be bolus(IV) after delivery of placenta to control postpartum bleeding, continuous fetal heart monitoring, have terbutaline avail to counteract effect |
what classification is Cytotec? | Prostaglandin analog |
what is the generic name for Cytotec? | misoprostol |
Use for Cytotec | cervical ripening and induction of labor. Tx of postpartum hemorrhage r/t uterine atony |
You should STOP the administration of Pitocin if: | contractions become less that q 2 min, greater than 90 seconds in duration, stronger than 85mmHg, or the resting tone is >30mmHg |
Action of Pitocin | stimulates uterine smooth muscle contraction and breakdown of collagen bundles in the cervix to increase flexibility and dialation in response to contractions |
what are 4 drugs that are used for postpartum hemorrhage? | methergine, pitocin, hemabate, cytotec |
contraindications of Cytotec | prior uterine scar, (C-Section), placenta previa, acute HSV out break, any other contraindication for vaginal delivery |
side effects of Cytotec | n/v/d headache |
nursing implications fo cytotec | monitor FHR & contraction pattern, monitor for hyperstimulation, monitor fundus/vaginal bleeding, record est blood loss, follow CBC until stable |
Trade name for Carbopost tromethamine | Hemabate |
Classification of Hemabate | Oxytocic |
contraindications include: pts w/ myocardial damage or cardiac block. Renal impairment | Magnesium Sulfate |
classification of Mag Sulfate | anti-convulsant; tocolytic |
action: stimulates myometrial contractions. Drug? | Hemabate |
contraindications of Hemabate? | ASTHMA, HTN, acute PID, active cardiac, renal or hepatic disease; labor |
some side effects include: N/V SEVERE DIARRHEA, elevated temp | Hemabate |
can you give Pitocin as an IV Push? | NO. Infuse via infusion pump during labor |
what are some nursing implications for Hemabate? | monitor uterine response and vaginal bleeding until stable, force fluids w/ pt w/ drug induced fever, save all expelled tissue, request prophylactic Tylenol and Lomotil |
decreased/absent reflexes may indicate toxicity | Magnesium sulfate |
Apply cold pack to IV site for tx of burning | Magnesioum Sulfate |
what is the antidote for Mag Sulfate? | calcium gluconate |
what are some side effects for Mag Sulfate? | resp depression or respiratory arrest, hypotension, CNS depression, muscle weakness, blurred vision, thirst |
A decreased rate of contractions indicates drug effectiveness in the premature labor pt. | Mag Sulfate |
Classification: Steriod Trade name: Celestone Soluspan | Betamethasone |
what is the use of Betamethasone? | accelerates lung maturity and prevents hyaline membrane disease in the premature infant. |
Betamethasone: action | stimulates release of stored surfactant in the fetus |
what are three contraindications of betamethasone? | adequate Lecithin/Sphingomyelin (L/S) ratio inability to delay delivery 24-48hrs delay of delivery is contraindicated |
resp depression, light-headiness, dizziness, N/V, constipation, sedation, decreased FHT variability are all side effects of? | Fentanyl |
binds with opiate receptors in the CNS altering the perception and emotional response to pain | Fentanyl |
classification: vaccine Trade Name: Meruvax II | Rubella virus vaccine |
discomfort at site, slight fever, lethargy, myalgia, splenomegaly are side effects of | Rhogam |
may initiate lactation, increases risk of infection, increases negative effects of placental insufficiency in PIH, increased risk of PE when used w/ a tocolytic, transient hyperglycemia especially in pts w/diabetes | Betamethasone |
Classification: Narcotic analgesic Generic name: Sublimaze Use: manage labor pain | Fentanyl |
stimulates immunity against rubella by introducing a LIVE virus | rubella virus vaccine; administered to women w/titer <1.000 |
classification: anti-infective Trade name: Ilotycin opthalmic action: kills susceptible microorganisms by attacking bacterial cell wall | Erythromycin |
side effect: temporary blurred vision | erythromycin |
most effective between 24-34 wks gestation, give deep IM in gluteal muscle to avoid muscle atrophy, course given once over two days during prego unless episodes of PTL are wide spread due to increased risk of fetal IUGR w/ repeated dosing | Betamethasone |
premature labor; latent phase labor; transition phase labor; fetal distress; maternal hemorrhage-contraindications for? | Fentanyl |
pregnancy, resp infection, other active infection-contraindications for? | Rubella virus vaccine |
encephalopathy, acute infection, anaphylaxis, fever, exposure during preg might lead to fetal birth defects including retardation and deafness | Rubella virus vaccine |
nursing implications for fentanyl | do not give w/ or after Stadol, in premature labor, fetal distress. Prevent injury for confused pt(elevate side rails, restrict bathroom privileges), monitor for resp depression, monitor o2 levels, caution in use <4hrs prior to delivery |
nursing implications for rubella virus vaccine | avoid pregnancy for at least 1 month after vaccine, obtain hx r/t allergies to other immunizations, chickens, ducks, feathers, or rabbits. Protect from light, store in fridge. Use if clear, red, pink, or yellow |